According to the CDC, by the year 2040, an estimated 78.4 million adults 18 years and older will have doctor-diagnosed arthritis. That’s more than 25% of the U.S. population. The prevalence of arthritis will continue to climb, and it is already the leading cause of disability in the United States.
Texas Orthopedics board-certified orthopedic surgeons treat osteoarthritis offering both conservative, non-surgical treatment options and joint replacement surgery. In addition, our board-certified rheumatologists treat rheumatoid arthritis and other autoimmune diseases that affect the musculoskeletal system.
We asked board-certified orthopedic surgeon and joint replacement specialist Dr. Benjamin McArthur to explain some general guidelines for managing and treating arthritis pain.
How can you manage arthritis pain?
Stick to low impact exercise. Arthritis pain is caused by the wearing away of cartilage, the body’s natural shock absorber for the joint. Low impact exercises like cycling, swimming and elliptical keep he body healthy and the joints mobile while avoiding excessive stress on vulnerable arthritic joints.
Maintain a healthy body weight. Keeping your weight down reduces the amount of pressure placed on your joints, particularly in the knees and hips. small amount of weight loss can have a big impact on arthritis pain.
Give Tai Chi a try. Tai Chi has been shown to be an excellent form of exercise for people with arthritis. It fosters improvements in strength, flexibility, balance, and positive thinking, all of which can go a long way towards optimizing joint function and limiting arthritis pain.
Don’t forget RICE. Rest, ice, compression and elevation are the best initial treatments for an arthritic joint that gets swollen and painful. Rest allows the body to begin naturally calming down a painful joint. Ice is a natural anti-inflammatory. Compression and elevation help the body reduce swelling which can contribute to arthritis pain.
Consider talking to your doctor about medication. There are a number of medical treatments for arthritis related pain. If the above measures done adequately don’t control our arthritis pain, talk to you doctor about what medications might be best for you.
What medications do you recommend for arthritis pain?
Ibuprofen. A non-steroidal anti-inflammatory drug (NSAID) frequently sold under the trade names Advil or Motrin, this medication can have a potent impact on inflammation when taken at the appropriate dose. Dosing schedule depends upon dose and can be every 4-6 hours or lower doses or every 8 hours for higher doses.
Naproxen. Another over the counter NSAID, often sold under the trade name Aleve, this medication is dosed every 12 hours.
Acetaminophen. Sold under the trade name Tylenol, this over the counter pain medication is not an NSAID, and thus can be an excellent alternative for patients who are advised not to take NSAIDs by their doctor. While studies have demonstrated improved efficacy of NSAIDs over Acetaminophen for arthritis pain relief, there are people for whom NSAIDs are not a safe option and for them Acetaminophen can be an excellent alternative. Tylenol Arthritis is a long acting higher dose formulation which has been marketed specifically for the purpose of treating arthritis pain.
Prescription NSAIDs. For patients with more severe arthritis pain which is not adequately managed with over the counter medications, there are a variety of prescription strength NSAIDs which can significantly reduce the day to day pains that can result from arthritic joints.
Dr. McArthur says it’s important to be aware that even over-the-counter medications can have hazardous effects in certain situations. People with kidney disease, heart disease, liver disease, history of gastric ulcers or severe gastroesophageal reflux are particularly vulnerable and should check with their physician before starting any new medications.
Can topical creams be used to alleviate arthritis pain?
Diclofenac 1% Gel. Sold under the brand name Voltaren, this topical cream required a prescription until earlier this year when it became available over the counter. Diclofenac is a potent NSAID and is also available as an oral pill, though oral Diclofenac requires a prescription. The advantage of the gel is tat it has a much lower rate of systemic absorption so for some patients who are not able to take oral NSAIDs, this topical cream may be an alternative. Again, this should be discussed with your physician.
Other topical creams with a variety of brand names include active ingredients such as camphor, menthol, and methyl salicylate. Salicylate is the active ingredient in aspirin, another over the counter NSAID. The ingredients of Vicks VapoRub, menthol and camphor, have primarily superficial effects, but can provide a soothing sensation over an arthritic joint that is inflamed.
What home remedies do you recommend for arthritis pain?
Glucosamine and Chondroitin. This dietary supplement has been shown in some small studies to result in some moderate symptomatic relief for arthritis pain. Its use is not universally recommended however as other studies have failed to show benefit. In general, it is a readily available and relatively safe supplement and may be worth a try for patients hoping to manage their symptoms without the use of prescription medications.
Warm water soaks. While ice can help to calm a swollen joint, a warm soak can help to relax those nearby muscles and alleviate feelings of stiffness. The addition of Epsom salt or your favorite essential oil may provide some additional soothing sensation or aroma.
Massage. While massage primarily focuses on the muscles, the relief of muscle tension and stiffness can have a positive impact on the adjacent joints, improving their mobility and reducing pain.
Mindfulness and meditation. Especially in the setting of chronic pain, we know that the brain’s pain pathways are hyperactive. The use of simple breathing exercises and mindfulness techniques can hep to reduce anxiety and pain.
Can certain foods make arthritis pain worse or better?
One of the primary mediators of arthritis pain is inflammation. There are a number of foods that have been shown to increase inflammation and would thus potentially predispose to making arthritis pain worse. Conversely, several foods have been shown to have anti-inflammatory effects and could thus make arthritis pain better. This is true for all types of arthritis, not just rheumatoid arthritis, since inflammation is often responsible for exacerbating arthritis pain.
Dr. McArthur instructs patients to visit Harvard Health for a list of pro-inflammatory and anti-inflammatory foods that can help guide dietary choices.
Pro-inflammatory Foods:
- refined carbohydrates, such as white bread and pastries
- French fries and other fried foods
- soda and other sugar-sweetened beverages
- red meat (burgers, steaks) and processed meat (hot dogs, sausage)
- margarine, shortening, and lard
Anti-inflammatory Foods:
- tomatoes
- olive oil
- green leafy vegetables, such as spinach, kale, and collards
- nuts like almonds and walnuts
- fatty fish like salmon, mackerel, tuna, and sardines
- fruits such as strawberries, blueberries, cherries, and oranges
- turmeric
If you have a painful, stiff or swollen joint, schedule an appointment with one of our board-certified orthopedic surgeons to learn more about the right treatment plan for your individual needs. You can book an appointment online or call (512) 439-1000 to schedule at any of our Austin area locations.
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